Managed Care/ACOs

Health care reform and the push for coordinated, “high value” healthcare is increasing the number and complexity of non-fee-for-service arrangements between third party payors, managed care organizations and providers.

Miller Health Law Group attorneys have been advising clients on managed care issues since the “dawn” of the managed care era in California, more than 25 years ago. Our work in the managed care area includes:

Preparation and negotiation of full medical risk, specialty capitation and preferred provider agreements

Evaluation of capitation rates and covered services

Preparation and negotiation of physician services agreements

Formation of full medical risk and specialty IPAs

ACO and HMO formation

Compliance with federal and state laws regulating HMOs and insurance companies